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Neurourol Urodyn. 2018 Jan;37(1):229-236. doi: 10.1002/nau.23279. Epub 2017 Apr 13.

Time to and predictors of dual incontinence in older nursing home admissions.

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School of Nursing, University of Minnesota, Minneapolis, Minnesota.
Division of Biostatistics, School of Public Health, Minneapolis, Minnesota.
College of Pharmacy, Minneapolis, Minnesota.



There are few studies of nursing home residents that have investigated the development of dual incontinence, perhaps the most severe type of incontinence as both urinary and fecal incontinence occur. To determine the time to and predictors of dual incontinence in older nursing home residents.


Using a cohort design, records of older nursing home admissions who were continent or had only urinary or only fecal incontinence (n = 39,181) were followed forward for report of dual incontinence. Four national US datasets containing potential predictors at multiple levels describing characteristics of nursing home residents, nursing homes (n = 445), and socioeconomic and sociodemographic status of the community surrounding nursing homes were analyzed. A Cox proportional hazard regression with nursing home-specific random effect was used.


At 6 months after admission, 28% of nursing home residents developed dual incontinence, at 1 year 42% did so, and at 2 years, 61% had dual incontinence. Significant predictors for time to developing dual incontinence were having urinary incontinence, greater functional or cognitive deficits, more comorbidities, older age, and lesser quality of nursing home care.


The development of dual incontinence is a major problem among nursing home residents. Predictors in this study offer guidance in developing interventions to prevent and reduce the time to developing this problem which may improve the quality of life of nursing residents.


aged; dual incontinence; epidemiology; incidence; incontinence; nursing homes; risk factors

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